INCREASING PATIENT SATISFACTION FOR UPPER LIMB ANAESTHESIA: A LOCAL SERVICE IMPROVEMENT PROJECT

Recovery of upper limb function after stroke is currently sub-optimal, despite good quality evidence showing that interventions enabling repetitive practice of task-specific activity are effective in improving function. Therapists need to access and engage with such evidence to optimise outcomes with people with stroke, but this is challenging in fast-paced stroke rehabilitation services. This quality improvement project aimed to investigate acceptability and service impact of a new, international tool for accessing evidence on upper limb rehabilitation after stroke—‘ViaTherapy’—in a team of community rehabilitation therapists. Semi-structured interviews were undertaken at baseline to determine confidence in, and barriers to, evidence-based practice (EBP) to support clinical decision making. Reported barriers included time, lack of access to evidence and a research-practice disconnect. The clinicians then integrated use of ‘ViaTherapy’ into their practice for 4 weeks. Follow-up interviews explored the accessibility of the tool in community rehabilitation practice, and its impact on clinician confidence, treatment planning and provision. Clinicians found the tool, used predominantly in mobile device app format, to be concise and simple to use, providing evidence ‘on-the-go’. Confidence in accessing and using EBP grew by 22% from baseline. Clinicans reported changes in intensity of delivery of interventions, as rapid access to recommended doses via the tool was available. Following this work, the participating health and social care service provider changed provision of therapists’ technology to enable use of apps. Barriers to use of EBP in stroke rehabilitation persist; the baseline situation here supported the need for more accessible means of integrating best evidence into clinical processes. This quality improvement project successfully integrated ViaTherapy into clinical practice, and found that the tool has potential to underpin positive changes in upper limb therapy service delivery after stroke, by increasing accessibility to, use of and confidence in EBP. Definitive evaluation is now indicated.

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A service improvement project exploring the extent of need for allied health care professionals within neuro-oncology in Velindre Cancer Centre.

Neuro-Oncology ◽

10.1093/neuonc/noz167.037 ◽

2019 ◽

Vol 21 (Supplement_4) ◽

pp. iv9-iv9

Author(s):

Rachel Evans ◽

Hayley Williams ◽

Lisa Love-Gould ◽

Owen Tilsley ◽

James Powell ◽

...

Keyword(s):

Patient Education ◽

Health Care Professionals ◽

Service Improvement ◽

Language Therapy ◽

Support Worker ◽

Improvement Project ◽

Cancer Centre ◽

Future Care ◽

Limited Opportunity ◽

Research And Education

Abstract Given the highly complex and holistic needs of neuro-oncology patients, gold standard guidelines recommend that support is best served by a coordinated multi-disciplinary team (MDT) to provide seamless care from diagnosis to end of life (NICE 2018). Allied Healthcare Professionals (AHPs) including occupational therapy (OT), physiotherapy (PT), speech and language therapy (SLT) and dietitians (DT) are recognised as key professions within the MDT. As there is no designated AHP team at Velindre Cancer Centre, input can be reactive and fragmented with limited opportunity for patient education or service developments. The aim of the project was to scope and evaluate the level of AHP need the neuro-oncology population attending Velindre Cancer Centre. A service improvement grant funded a Band 4 Therapies support worker to conduct the project. The project involved a number of elements including the implementation of a revised neuro-oncology screening tool, strategic effort to improve patient education and self-management and engaging patients and staff to guide future service developments. The mixed methods approach yielded rich quantitative and qualitative data. The results demonstrated that whilst AHP input was beneficial to patient care, significant unmet needs were highlighted and demands for services exceeded the teams’ capacity. Therefore a designated neuro-oncology therapies team should be a central consideration for future care to enable timely, responsive, equitable and seamless MDT working. Greater AHP resource would also enable greater AHP involvement in research and education to revolutionise care in order to fully meet the needs of this vulnerable and complex patient group.

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An investigation of the knowledge of intimate partner violence among clinical staff working with male substance misusers

Advances in Dual Diagnosis ◽

10.1108/add-02-2019-0001 ◽

2019 ◽

Vol 12 (3) ◽

pp. 105-116

Author(s):

M. Aurora Falcone ◽

Tim Meynen

Keyword(s):

Intimate Partner Violence ◽

Partner Violence ◽

Intimate Partner ◽

Clinical Staff ◽

Service Improvement ◽

Improvement Project ◽

Senior Staff ◽

Content Type ◽

Knowledge And Skills ◽

Drug And Alcohol

Purpose The purpose of this paper is to describe a Service Improvement Project aimed at assessing the level of knowledge of intimate partner violence (IPV) of clinical staff working in Community Drug and Alcohol Services (CDAS) in four boroughs of South London. Design/methodology/approach Clinical staff (n=90) completed a survey which was based on the Capability Framework (Hughes et al., 2015), developed to describe the key capabilities required to work with men who misuse drug and alcohol and perpetrate IPV. Two separate surveys were prepared for clinical (core) staff (n=76) and for manager (senior) staff (n=14). Findings The Capability Framework provided a useful structure for identifying key strengths and gaps in knowledge and skills related to substance use and IPV treatment in frontline CDAS staff. Significant strengths which emerged in the “core staff” survey related to the importance of assessing IPV and being empathic. Gaps related to the confidence in working with these issues and receiving support. Significant strengths which emerged in the “senior staff” survey related to the availability of supervision, information and training on IPV. Gaps related to using the Capability Framework and discussing IPV in supervision. Originality/value Findings have important implications for the development of training addressing gaps in current knowledge and skills required when working with IPV in the context of drug and alcohol misuse.

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User preference for HIV self-testing or self-sampling within a free online sexual health service: a service evaluation

International Journal of STD & AIDS ◽

10.1177/0956462419868882 ◽

2019 ◽

Vol 30 (12) ◽

pp. 1239-1242

Author(s):

Paula Baraitser ◽

Adam Black ◽

Stuart Amos-Gibbs ◽

Gillian Holdsworth ◽

Elena Ardines ◽

...

Keyword(s):

Health Service ◽

Sexual Health ◽

Hiv Testing ◽

Service Evaluation ◽

User Preference ◽

Service Improvement ◽

Improvement Project ◽

Advantages And Disadvantages ◽

Self Testing ◽

Sexual Health Service

The objective of this study was to evaluate a service improvement project offering HIV testing through either self-testing or self-sampling in an online sexual health service by measuring type of test chosen and the reason for this choice. We created a web-page offering choice of online self-sampling or self-testing with information on the advantages and disadvantages of both methods. Anyone aged over 18 years resident in England, Scotland or Wales could order either type of test. We describe the characteristics of users, the tests chosen and the reasons for the choice. A total of 1502 HIV testing orders were placed and 1466 (97.6%) testing kits were dispatched after exclusion of multiple orders by the same user. Sixty-seven per cent of users chose self-testing (n = 984) and the rest chose self-sampling (n = 482, 32.9%). The most frequent reasons for choosing self-testing were: immediate results (n = 264, 46.9%), ability to complete the test themselves (n = 168, 29.8%), less blood required (n = 67, 11.9%) and the privacy of testing at home (n = 55, 9.8%). Public sector provision of self-testing as an adjunct to clinic-based HIV testing services is likely to be highly acceptable to UK populations. However, a proportion will prefer self-sampling, and maintaining choice of testing modality is important.

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